ElderPlace- PACE Seattle Volunteer Application Form

Please complete this application form if you are interested in becoming a Providence ElderPlace volunteer. Once you complete the form, click the Continue button at the bottom.

Name and address

Demographic Information

You may optionally provide the following information. It is used only to help us better serve our participants by better meeting their cultural needs.

Emergency Contact

Please indicate who you'd like us to call in an emergency


Please indicate the days and times you are usually available to volunteer.

Interest in Volunteering

How did you hear about us and why do you want to volunteer?

Personal Skills & Interests

What special services/skills or hobbies (art, music, languages, grant-writing, website design, public relations, hairdresser, etc.) do you feel you can incorporate into your volunteer work?

Work/Education/Special Training

Please tell us about your current or previous work experience, education, or special training.


All in person volunteers with Providence are required to attend a general orientation to Providence ElderPlace, receive training specific to their role, obtain a TB test , and obtain an influenza vaccine and a COVID19 vaccine.(provided by Providence)

Background Checks

All volunteers must successfully pass a background check prior to beginning service with Providence.

Conviction of a crime will not necessarily be a bar to volunteer service. Factors such as type and nature of conviction(s) will be taken into account in determining effect on suitability for volunteering.


Please supply three references. If you have prior volunteer experience, please include one of your supervisors.


I understand that I am applying for a volunteer position with Providence ElderPlace of Seattle.
I consent to and authorize the agency and its personnel to ask any of the references I have listed for relevant information that may concern my performance as a volunteer for the agency. I therefore release all parties and persons connected with any request for information from all claims, liabilityand damages for whatever reason arising out of furnishing the information.

I certify that the information provided on this application is true and complete to the best of my knowledge. Furthermore, I agree to all background checks required by this agency.